Mercury News editorial: ACA's halting progres is -- still progress

Sunday marks the four-year anniversary of President Obama's Affordable Care Act, and it has been a rocky road.

Massive health care reform never was expected to be easy, and it has lived up to that expectation. But Obama's major domestic legacy is improving the lives of Californians. And to this day, nobody has come up with an alternative to bring the United States' health care system up to the standard of other industrialized countries.

In this state alone, more than 1 million people, many of them previously uninsured, have signed up for Covered California. Another 2 million were added to Medi-Cal rolls and about 430,000 young adults are covered by parents' plans.

This March 1 photo shows part of the website for HealthCare.gov. (AP Photo)

The number of uninsured Californians is dropping steadily, the health insurance market is more robust, no one is denied insurance because of pre-existing conditions and billions of federal dollars are pouring into the state. This is real progress.

Republicans decry "Obamacare" and are making it their top issue for this fall's elections. But it's hard to imagine repealing it all and tossing millions of Americans back into the abyss. While the ACA is far from reaching its goals, it is making a difference in many lives.

And no GOP leader has offered a viable alternative, including the 2016 presidential field. Former House Speaker Newt Gingrich says this would be the perfect time to roll out a GOP solution, but even he admits that Republicans have "zero" ideas.

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Jeb Bush touts risk-adjusted premiums, a timeworn proposal that benefits the wealthy and does nothing for the uninsured.

Chris Christie calls for more debate on health care -- as if nobody's had a chance to talk about it -- and suggests tort reform. That's like saying California would have enough water if it patched leaky pipes. Rand Paul would replace the ACA with a free-market approach -- which is exactly what we had before, when insurance companies were lopping the sick off their rolls and pricing the poor out of the game.

That said, we're still a long way from a functioning health care system. An estimated 3 million Californians still don't have coverage and will burden emergency rooms at public cost. Another 250,000 with incomes just over the poverty line have seen premiums increase. Reimbursement rates for hospitals and doctors have to improve.

California representatives should press the president and Congress to expand eligibility in states with a high cost of living. Gov. Jerry Brown should find ways to increase incentives for doctors to accept Medi-Cal patients.

Four years ago we called the Affordable Care Act a hard-fought victory showing that real change still is possible in America. We'll stand by that.

A lot of hard work remains to achieve its goals, but the halting progress we have seen is progress nonetheless, and cause for hope for millions of Americans now denied care.